Eye Bag Surgery | Benefits, Risks, and Recovery Time

Lower eyelid surgery, also known as lower blepharoplasty, is a cosmetic procedure that helps correct loose skin, excess fat, and wrinkles in the lower eye area.

As you age, your skin naturally loses elasticity and the fatty padding beneath it. This can make the lower eyelids look puffy, wrinkled, and droopy. Lower eyelid surgery can smooth the area under the eyes, creating a more refreshed and youthful appearance.

How Much Does Lower Eyelid Surgery Cost?

According to the American Society of Plastic Surgeons, the average cost of eyelid surgery is about $3,026. This amount can vary depending on your location, the surgeon’s experience, and other factors. This figure usually refers to the surgeon’s fee only and does not include operating room facility fees or anesthesia, which will differ based on where you live and your specific needs.

Because this procedure is typically elective, it’s unlikely to be covered by insurance. The overall cost will be higher if you have both upper and lower eyelids treated. Your surgeon can provide a detailed cost estimate before your operation.

How Does Lower Eyelid Surgery Work?

Lower blepharoplasty works by removing excess skin and fat, then tightening and suturing the skin under the eye to create a smoother, firmer look.

The lower eyelid area contains delicate structures, including the eye muscles and the eyeball itself. For this reason, the operation requires a precise, meticulous technique to flatten the under-eye area and reduce puffiness without damaging nearby tissues.

The Lower Eyelid Procedure

There are several surgical techniques for lower eyelid surgery. The specific approach depends on your goals for the under-eye area and your individual anatomy.

Before surgery, your surgeon will mark your eyelids. These markings guide where the incisions will be placed, and this is usually done while you are sitting upright so the surgeon can better assess the eye bags.

The procedure can be done under general or local anesthesia. General anesthesia means you are completely asleep and unaware of the surgery. Local anesthesia numbs the eye area while you remain awake and comfortable.

If you are having multiple procedures at the same time, your doctor is more likely to recommend general anesthesia. If you are having lower eyelid surgery alone, your doctor may suggest local anesthesia; one advantage is that the surgeon can assess your eye muscle function during the procedure, which may help lower the risk of certain complications.

Although incision sites can vary, the surgeon typically makes cuts along the lower eyelid. Excess skin and fat are then removed, and the skin is sutured back together to create a smoother, lifted appearance.

Your surgeon may also recommend fat grafting or fat injections into hollow areas under the eyes to restore lost volume and improve contour.

Target Areas for Lower Eyelid Surgery

Lower eyelid surgery can be used to address the following cosmetic concerns:

– Under-eye bags and puffiness  

– Loose or sagging skin under the eyes  

– Fine lines and wrinkles of the lower eyelid  

– Hollow or sunken areas beneath the eyes  

It’s important to speak openly with your surgeon about what bothers you in the lower eye area and the type of results you can realistically expect.

Are There Risks or Side Effects?

Your surgeon should review all risks and possible side effects with you before the procedure. Potential risks include:

– Bleeding  

– Infection  

– Noticeable scarring  

– Dry eyes or irritation  

– Difficulty closing the eyes completely  

– Changes in eyelid position (ectropion or retraction)  

– Blurred or double vision (usually temporary)  

– Asymmetry or unsatisfactory cosmetic result  

– Need for revision surgery  

– Rarely, vision loss  

You may also experience side effects related to medications or anesthesia used during surgery. Always tell your doctor about any allergies you have, as well as all medications and supplements you are taking. This helps reduce the risk of drug interactions and complications.

What to Expect After Eyelid Surgery

Lower eyelid surgery is usually performed on an outpatient basis, unless it is combined with other procedures that require an overnight stay.

Your doctor will give you detailed post-operative care instructions. These usually include using cold compresses for about 48 hours after surgery to help decrease swelling.

You’ll likely be prescribed eye ointments and/or eye drops to help prevent infection and keep the eyes lubricated. Expect some bruising, eye dryness, swelling, and general discomfort in the days following surgery.

You’ll typically be advised to avoid strenuous exercise for at least one week. You should also wear dark sunglasses to protect your eyes while the skin is healing. If non-absorbable stitches are used, they are usually removed about five to seven days after surgery.

In most cases, swelling and bruising improve significantly within 10 to 14 days, and many people feel more comfortable being in public at that point.

Always contact your surgeon if you develop symptoms that may suggest a post-operative complication, such as severe pain, sudden vision changes, increasing redness or swelling, or discharge.

Keep in mind that you will continue to age after surgery. This means that skin may eventually begin to sag or wrinkle again over time. Your final result will depend on factors such as:

– Your age at the time of surgery  

– Skin quality and thickness  

– Sun exposure and lifestyle habits (e.g., smoking)  

– Your overall health and healing ability  

– The surgeon’s technique  

Preparing for Lower Eyelid Surgery

Once you decide to proceed, schedule your surgery date. Your doctor will give you pre-operative instructions. These may include not eating or drinking anything after midnight the night before your surgery.

Your doctor may also prescribe eye drops or other medications to start before surgery. You should arrange for someone to drive you home afterward and prepare your home with the items you’ll need during recovery. Examples include:

– Cold packs or gel ice masks  

– Prescribed eye drops and ointments  

– Over-the-counter pain relievers approved by your surgeon  

– Extra pillows to keep your head elevated  

– Gentle cleanser and clean towels  

– Sunglasses with good UV protection  

Ask your surgeon if there are any specific skin-care products or other preparations they recommend before your procedure.

Lower Eyelid Surgery vs. Alternative Treatments

If your lower eyelid skin laxity is mild to moderate, you can discuss non-surgical treatments with your doctor. Options may include laser skin resurfacing and dermal fillers.

Laser Skin Resurfacing

Laser skin resurfacing uses devices such as carbon dioxide (CO₂) lasers or Erbium:YAG lasers. Targeting the skin with laser energy can stimulate collagen production and tighten the skin.

Laser treatments are not suitable for everyone. People with darker skin tones, in particular, may wish to avoid certain laser procedures because they can increase the risk of hyperpigmentation or uneven skin color.

Dermal Fillers

Another alternative is dermal fillers. Although fillers are not specifically approved by the U.S. Food and Drug Administration (FDA) for treating under-eye concerns, some plastic surgeons and dermatologists use them off-label to improve the appearance of the tear trough and under-eye hollows.

Most fillers used under the eyes are based on hyaluronic acid and are injected to restore volume and create a smoother contour beneath the eyes. The body gradually absorbs these fillers over time, making them a temporary solution for volume loss in the under-eye area.

However, some people may not achieve the desired result with laser treatments or fillers. If the lower eyelid remains a significant cosmetic concern, your doctor may recommend lower eyelid surgery as a more definitive option.